Vaginal colonization by orally consumed lactobacilli in healthy women

ISRCTN ISRCTN29375062
DOI https://doi.org/10.1186/ISRCTN29375062
IRAS number 287782
Secondary identifying numbers NH-05173, IRAS 287782
Submission date
08/09/2020
Registration date
16/09/2020
Last edited
21/02/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Urological and Genital Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
This study has been designed to investigate the effect of a probiotic supplement on the natural bacteria of the vagina in healthy women. A healthy environment (microflora) in the vagina is supported by the presence of large numbers of certain bacteria called lactobacilli. Lower numbers of these bacteria have been associated with a risk of health problems such as bacterial vaginosis (BV), yeast infections such as thrush, and urinary tract infections (UTIs).
It is believed that taking a regular probiotic supplement containing lactobacilli by mouth can help increase the numbers of lactobacillus bacteria in the vagina. The reason for this is not entirely clear, but initial studies in both mice and healthy women have successfully shown this effect on the vaginal microflora. While similar studies have already been done, this study is different because it will look at the effects of only two specific lactobacillus bacteria in the probiotic supplement.

Who can participate?
Caucasian women between the age of 18 and 50 who have not have had any vaginal infections in the past 6 months and are willing to use a valid form of contraception throughout the study.

What does the study involve?
The study involves a total of five clinic visits over a period of up to about 2 months. Participants are randomly allocated to one of two groups. One group will be given capsules containing lactobacillus bacteria and the second group will be given placebo (dummy) capsules. During the supplementation period (14 days between Visit 2 and Visit 4) each participant will consume one capsule orally every day after breakfast. The numbers of lactobacillus bacteria in the vagina is measured at the start of the study and at day 7, day 14 and day 21.

What are the possible benefits and risks of participating?
There are no definite benefits for taking part in this study. It is possible that the probiotic supplement could have an effect on helping maintain a vaginal microflora considered healthy. There are no specific risks are anticipated in relation to the study product when taken by otherwise healthy people. Any potential side effects are unexpected but may include mild and transient symptoms related to the digestive tract, such as tummy discomfort, bloating, or wind. As with any food product, there is a possible risk of allergy to the ingredients of the study product.

Where is the study run from?
CPS Research (UK)

When is the study starting and how long is it expected to run for?
May 2020 to March 2021

Who is funding the study?
Danisco Sweeteners Oy (Finland)

Who is the main contact?
Anna Lyra, anna.h.lyra@iff.com

Contact information

Ms Anna Lyra
Scientific

Danisco Sweeteners Oy
Sokeritehtaantie 20
Kantvik
Fl-02460
Finland

Phone +358 (0)104312235
Email anna.h.lyra@iff.com

Study information

Study designTwo-arm double-blind randomized placebo-controlled parallel-group single-centre study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Other
Study typeTreatment
Participant information sheet Not available in web format, please use contact details to request a participant information sheet
Scientific titleVaginal colonization of lactobacillus acidophilus and lacticaseibacillus rhamnosus in healthy females: a double-blind, randomized, placebo-controlled trial
Study acronymSG-FREYA
Study objectivesThe primary objective of the study is to show the difference between verum supplementation and placebo in the vaginal colonization of L. acidophilus and L. rhamnosus during and after 2 weeks supplementation of verum containing L. acidophilus and L. rhamnosus.
Ethics approval(s)Approved 09/10/2020, East of Scotland Research Ethics Service REC 1 (Ninewells Hospital & Medical School, Tayside Medical Science Centre (TASC), Residency Block, Level 3, George Pirie Way, Dundee, DD1 9SY, UK; +44 (0)1382 383871; Tay.eosres@nhs.net), REC ref: 20/ES/0089
Health condition(s) or problem(s) studiedVaginal health
InterventionParticipants will be screened at the screening visit (Visit 1) to check that all the inclusion criteria and none of the exclusion criteria are met. The eligibility will be confirmed before Visit 2 based on the laboratory results (vaginal swab: Nugent score (for BV) and Chlamydia and trichomoniasis) taken at Visit 1.

Randomization will be carried out with a computer-generated random allocation of study participants to one of two treatment groups in equal proportions using randomly permuted blocks.

After randomization at baseline (Visit 2), two groups will be provided with IP (dietary supplement): one group will be supplemented with capsules containing a mixture of the active ingredients at the intended daily dose of 1 x 10(10) CFUs probiotics L. acidophilus and L. rhamnosus mixed with a carrier (maltodextrin) and a second group will consume placebo capsules containing carrier only. At randomization (Visit 2) and at Visit 3, each participant will receive one bottle of 10 capsules including capsules for each 7-day supplementation period.

During the supplementation period (14 days between Visit 2 and Visit 4) each participant will consume 1 capsule orally every day after breakfast, starting from the day after (Day 1) the baseline visit (Visit 2).
Intervention typeSupplement
Primary outcome measureVaginal colonization of L. acidophilus and L. rhamnosus measured with quantitative PCR at baseline, day 7, day 14 and day 21
Secondary outcome measuresVaginal pH measured with pH test strips baseline, day 7, day 14 and day 21

Exploratory analyses include assessment of vaginal microbiota composition and immunological markers
Overall study start date07/05/2020
Completion date24/03/2021

Eligibility

Participant type(s)Healthy volunteer
Age groupAdult
Lower age limit18 Years
SexFemale
Target number of participants50
Total final enrolment50
Key inclusion criteria1. Female
2. Age 18–50 years (fertile age)
3. Caucasian
4. No vaginal infections within the previous 6 months
5. Has not participated in another investigational drug clinical trial within 1 month (30 days) or received an investigational drug within the last month (30 days) before the start of screening
6. No significant changes in daily routines related to dietary/activity patterns
7. Willingness to take dietary supplements
8. Valid contraception for the duration of the study:
8.1. Use of oral, (estrogen and progesterone), injected or implanted hormonal methods of contraception or placement of an intrauterine device (IUD) or intrauterine system (IUS), or other forms of hormonal contraception that have comparable efficacy
8.2. Total abstinence (when this is in line with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception
8.3. Female sterilization (have had surgical bilateral oophorectomy with or without hysterectomy), total hysterectomy, or bilateral tubal ligation at least six weeks before taking study treatment.
8.4. Male sterilization (at least 6 months prior to screening). For female subjects on the study, the vasectomized male partner should be the sole partner for that subject
8.5. Barrier contraceptive (condoms)
9. Willingness to collaboration in completing the binding parts of the study protocol
Key exclusion criteria1. Vaginal or urinary complaints within 3 months
2. Vaginal pH > 4.5
3. Pregnant or planning pregnancy
4. Breastfeeding
5. History of significant vulvo-vaginal pathological conditions
6. Antibiotic usage during last 3 months
7. Oral corticosteroid usage during last 3 months
8. Use of vulvo-vaginal medication
9. Acquired or congenital immune deficiency
10. Recent history of radiotherapy (within 2 years)
11. Current or prolonged (more than 1 month in last 2 years) use of corticosteroids or other immune modulating medication. Inhaled corticosteroids for asthma are not considered as an exclusion if their usage has begun more than 3 months prior to recruitment
12. Habitual use of probiotic supplementation
13. Menstrual irregularities including menopause
14. On-going diagnosed disease which in the opinion of the investigator makes the participant unfit for the study
15. Intolerance to any of the study products
16. History of alcohol abuse within 2 years
17. History of drug abuse within 2 years
18. Unable to communicate with the investigator
19. Positive culture from swabs at visit 1 or Nugent score >3 (added 05/01/2021)
Date of first enrolment05/11/2020
Date of final enrolment28/02/2021

Locations

Countries of recruitment

  • Scotland
  • United Kingdom

Study participating centre

CPS Research
3 Todd Campus
West of Scotland Science Park
Glasgow
G20 0XA
United Kingdom

Sponsor information

Danisco Sweeteners Oy (Finland)
Industry

Sokeritehtaantie 20
Kantvik
FI-02460
Finland

Phone +358 (0)10 431 2235
Email alvin.ibarra@iff.com
Website http://iff.com
ROR logo "ROR" https://ror.org/02nqcmv36

Funders

Funder type

Industry

Danisco Sweeteners Oy (Finland)

No information available

Results and Publications

Intention to publish date31/05/2023
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planPlanned publication in a high-impact peer-reviewed journal. Full study protocol and statistical analyses plan won’t be available, but all the study methods and statistical analyses will be reported in the publication in detail.
IPD sharing planThe Trial Master File of the study, containing pseudo-anonymized data, will be stored by the Sponsor for 25 years. At the moment, it is not planned to make the pseudo-anonymized data publicly available.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 16/02/2023 21/02/2023 Yes No
HRA research summary 28/06/2023 No No

Editorial Notes

21/02/2023: Publication reference added.
16/06/2022: The following changes have been made:
1. The final enrolment number has been added.
2. The overall trial end date has been changed from 31/05/2021 to 24/03/2021 and the plain English summary updated accordingly.
3. The intention to publish date has been changed from 31/12/2022 to 31/05/2023.
18/11/2021: The following changes were made to the trial record:
1. The primary contact was updated.
2. The intention to publish date was changed from 31/12/2021 to 31/12/2022.
3. The plain English summary was updated to reflect these changes.
17/02/2021: The sponsor organisation and funder name have been updated.
12/02/2021: The scientific contact email and sponsor contact email have been updated.
05/01/2021: The exclusion criteria were updated.
26/10/2020: The following changes were made to the trial record:
1. The ethics approval details were added.
2. The recruitment start date was changed from 01/10/2020 to 05/11/2020.
14/09/2020: Trial's existence confirmed by East of Scotland Research Ethics Service REC 1.